| NPI | 1689354078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER MOGILNER Owner 516-984-7327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261Q00000X | |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2023-10-19 |